Thoracic Oncology Dept, Hôpital Larrey, University Hospital of Toulouse, Toulouse, France
Cancer Research Centre of Toulouse (CRCT), Inserm, University of Toulouse III - Paul Sabatier, National Scientific Research Centre (CNRS), Toulouse, France.
Eur Respir Rev. 2020 Feb 12;29(155). doi: 10.1183/16000617.0052-2019. Print 2020 Mar 31.
Liquid biopsy refers to the analysis of any tumour-derived material circulating in the blood or any other body fluid. This concept is particularly relevant in lung cancer as the tumour is often difficult to reach and may need an invasive and potentially harmful procedure. Moreover, the multitude of anticancer drugs and their sequential use underline the importance of conducting an iterative assessment of tumour biology. Liquid biopsies can noninvasively detect any targetable genomic alteration and guide corresponding targeted therapy, in addition to monitoring response to treatment and exploring the genetic changes at resistance, overcoming spatial and temporal heterogeneity.In this article, we review the available data in the field, which suggest the potential of liquid biopsy in the area of lung cancer, with a particular focus on cell-free DNA and circulating tumour cells. We discuss their respective applications in patient selection and monitoring through targeted therapy, as well as immune checkpoint inhibitors. The current data and future applications of liquid biopsy in the early stage setting are also investigated.Liquid biopsy has the potential to help manage nonsmall cell lung cancer throughout all stages of lung cancer: screening, minimal residual disease detection to guide adjuvant treatment, early detection of relapse, systemic treatment initiation and monitoring of response (targeted or immune therapy), and resistance genotyping.
液体活检是指对血液或其他体液中任何肿瘤来源物质的分析。这一概念在肺癌中尤为重要，因为肿瘤通常难以到达，可能需要进行侵入性且潜在有害的操作。此外，大量的抗癌药物及其序贯使用凸显了对肿瘤生物学进行迭代评估的重要性。液体活检可以非侵入性地检测任何可靶向的基因组改变，并指导相应的靶向治疗，此外还可以监测治疗反应和探索耐药时的遗传变化，克服空间和时间异质性。在本文中，我们回顾了该领域的现有数据，这些数据表明液体活检在肺癌领域具有潜力，特别是在游离 DNA 和循环肿瘤细胞方面。我们讨论了它们在通过靶向治疗选择和监测患者方面的各自应用，以及免疫检查点抑制剂。还研究了液体活检在早期阶段的当前数据和未来应用。液体活检有可能帮助管理非小细胞肺癌的所有阶段：筛查、微小残留病灶检测以指导辅助治疗、早期复发检测、系统治疗开始和监测反应（靶向或免疫治疗）以及耐药基因分型。
